Oxted Rotary Christmas Family Foodparcel Campaign

Registered charity number: 1043204

We are targeting needy families the Oxted area at Christmas time. Oxted Rotary Club is a Referral Angency for the Caterham Fodbank and Hampers will be awarded by the club to successful applicants in the immediate run-up to Christmas.

Applications

We are inviting applications directly from individuals, family members and from support agencies such as social and support services, housing associations, refuge and rehabilitation organisations. Where applicable, support agencies must have personal, ongoing knowledge of the applicant and their family’s situation.

Eligibility Criteria

Applications will be considered from parents with one or more children under the age of 18 and to families living with a disability.

How to Apply

If you believe that you meet the eligibility criteria, please complete this application form or ask someone to complete one on your behalf. Applications using this form do not need a proposer.

Applications can only be made by or on behalf of those who live in areas where the Rotary Club of Oxted & Limpsfield operates. These are:

Oxted and Old Oxted, Limpsfield and Limpsfield Chart, Hurst Green & Holland, Tandridge and Titsey

Hampers

The value of Hampers will depend on the circumstances of the family applying and will be entirely at the discretion of the Oxted Rotary Club.

We cannot consider applications from organisations providing ‘one-off’ or ‘drop-in’ support or advice

How to apply

Applications can be submitted at any time until the closing date of 18th November and successful applicants will be issued with their hampers during week beginning 4th December.

Guidance Notes

Before completing this form, please ensure that your application meets the Eligibility Criteria outlined above and please remember – we want you to succeed in your application, so if you have any difficulty in filling out this form or you find it at all daunting, please contact the Grants Administrator by email at grants@oxtedrotary.org.uk.

1 Applicant: Only parent/s who live with a child or children under the age of eighteen or families living with a disability should apply. You may apply if you have more than one child, in which case please include their first names and ages in the boxes provided.

2 Proposer: Not required for this application, which is only for a Christmas Hamper.

3 Applicant’s Circumstances: Please provide all information that you can to help support your application. This should include details of financial hardship, illness or long term disability that is affecting you and your family’s quality of life. We need you to show us that you are deserving of our help and we will, of course, keep anything you tell us completely confidential.

5 Data Protection: We will keep this application form until such time as it has been decided whether or not you will receive funds from us. Whether you are successful or not, we will destroy all information relating to your application once that decision has been made. By signing the declaration, you agree to this.

URN - if you have applied for a grant from us in previous years, you will have been given a unique identification number, e.g 034. Please insert that number here and on all future correspondence with us;

How many parents are there in your family?*

OneTwo

Parent 1*

First NameLast Name

Parent 2*

First NameLast Name

How many children do you have?*

OneTwoThreeFour

First name and Age of Child 1*

First NameAge

First name and Age of Child 2*

First NameAge

First name and Age of Child 3*

First NameAge

First name and Age of Child 4*

First NameAge

Telephone number*

Email Address*

Home Address*

Street Address Line 1

Street Address Line 2

TownCounty

Post Code

Does anyone in your family have any special dietary requirements or restrictions?*

YesNo

Please describe the dietary restrictions*

Please tell us all about you and your family*

Please tell us which benefits you receive - tick as many as apply;

Please tell us about any long term illness or disability that your your family is living with*

Declaration by Applicant: Do you, to the best of your knowledge and understanding, declare that everything you have told us is true? Do you understand that the Trust will keep everything you have told us completely confidential until it has been decided whether or not you will receive a Christmas Hamper (see Guideline 5)?*

YesNo

And finally, could you please tell us how you learned about our grants?

Signature*

Date*

The 'Oxted Rotary' Charitable Trust

Section 1 - Applicant's Details

Section 2 - Applicant's Circumstances